ismailalmokyad's version from 2018-01-25 19:46


Question Answer
1-wt is Clinical features of melanoma on examABCDE
1-Asymmetry: When bisected, the 2 sides are not identical
2-Border irregularities: Uneven edges, pigment fading off
3-Color variegation: Variable mixtures of brown, tan, black & red
4-Diameter: ≥6 mm
5-Evolving: Lesion changing in size, shape, or color; new lesion
2- what is herald patchpruritic patches, 2–10 cm pink/tan colored, scaly with a raised border lesion which usually appears on the back and is an early sign of pityriasis rosea. Within several days, numerous similar but smaller lesions are usually seen. it is self limited in 2 months.
3-wt is Giardiasis and wt is risk factor**protozoan**
1-Exposure to contaminated food or water(during camping or hiking )
2-Fecal incontinence & crowding (eg, day care facilities, nursing homes)
4-presentation of Giardiasis1-Acute
-Loose, foul-smelling, fatty stools
-Abdominal cramps
-Weight loss

-Malabsorption (eg, lactose intolerance)
-Profound weight loss
-Vitamin deficiencies
5- treatment of Giardiasis-Metronidazole (symptomatic or high-risk patients only).

-prevent infection by hand hygiene and avoid swimming in pools until symptoms have resolved for 2 weeks.
6-Parvovirus B19 c/p, dx, and ttt1-Clinical presentation
-Flu-like illness
-“Slapped cheek” rash (in children)
-Lacy, reticular rash (mainly older)
-Small-joint, symmetric polyarthritis(older)
-Transient aplastic anemia

-Parvovirus B19 serology


-No long-term sequelae
7-Intussusception risk factors-Recent viral illness or rotavirus vaccination
-Meckel diverticulum
-Henoch-Schönlein purpura
-Celiac disease
-Intestinal tumor
8-c/p of Intussusception** age 6 months to 3 years.**
1-Sudden, intermittent abdominal pain
2-“Currant jelly” stools
3-Sausage-shaped abdominal mass
4-Lethargy or AMS
9-Intussusception dx and ttt1-Diagnosis
“Target sign” on ultrasound

-Air or saline enema or water-soluble enema.
-Surgery for removal of lead point
10-complication of intussusceptionischemia and perforation.
-perforation as result of enema (<1%)
-recur of intussusception after ttt is 10%
11- causes of hypocalcemia post parathyroidectomy1- relative hypoparathyroidism bc of long suppression of parthyroid it may fail to response to low ca level, usually transient and pt recover in few days.

2-hungry bone syndrome sudden withdrawal of PTH in patients with severe hyperparathyroidism, causing an increased influx of calcium from the circulation into the bone. develops 2 to 4 days following surgery.

Preoperative risk factors for hungry bone syndrome are
-severe hyperparathyroidism
-severe bone disease
-vitamin D deficiency.
12- risk for Inguinal hernia in children-Premature boys
13-c/p of Inguinal hernia in children-Asymptomatic groin mass
-Increases with abdominal pressure (eg, Valsalva)
14-complication of Inguinal hernia in children1-Incarceration (up to 13%) in which the mass is entrapped in the scrotum and may lead to impaired fertility, testicular atrophy. Signs of incarceration include
-abdominal distension
-scrotal pain

2-Bowel ischemia
15-management of Inguinal hernia in children-Asymptomatic: Elective surgery in 1-2 weeks treatment delay of >2 weeks after diagnosis doubles the risk of incarceration.
-Immediate surgical repair for incarceration
16- etiology of cardiac tamponade1-Aortic aneurysm or postmyocardial infarction
2-Malignancy or radiation therapy
3-Infection (eg, viral, tuberculosis)
4-Connective tissue disease (eg, SLE)
5-Cardiovascular surgery
17-c/p of cardiac tamponade-Beck triad: Hypotension, JVD, ↓ heart sounds
-Pulsus paradoxus (SBP ↓ >10 mm Hg with inspiration)
18-dx of cardiac tamponed-ECG: Low-voltage QRS, electrical alternans
-Chest x-ray: Enlarged cardiac silhouette, clear lungs
-Echocardiogram: Right atrial & ventricular collapse, plethora of the IVC
19- can a doctor give blood to a child of Jehovah's Witness against the parent wishesyes, parent, cannot refuse life-sustaining treatment for a child who has not reached the age of consent and has not chosen to adhere to the religion.
20-wt is the treatment of Hyperemesis Gravidarum-fluid
-vit B6 (pyridoxin) +/- doxylamin
21-wt is side effects of Selective estrogen receptor modulators1-Hot flashes
2-Venous thromboembolism
3-Endometrial hyperplasia & carcinoma (tamoxifen only)
22-how to manage recurrent pneumonia in the same lobe in a short period1-CT to look for neoplasm obstruction, lung abscess, empyema.

2-IF CT is not helpful do bronchoscopy to look for other causes as TB, fungus, inflammatory conditions mimicking pneumonia.

3-If both CT and bronchoscopy not helpful then do Open lung biopsy.
23-wt is metablic/neutritonal Secondary causes of osteoporosis-Calcium &/or vitamin D deficiency
-Eating disorders
24-wt is GI/hepatic Secondary causes of osteoporosis-Malabsorption (eg, celiac disease, Crohn disease)
-Chronic liver disease
-Bariatric procedures
25-wt is renal Secondary causes of osteoporosis-Chronic kidney disease
-Renal tubular acidosis
26-wt is medication Secondary causes of osteoporosis-Glucocorticoids
-Proton pump inhibitors
-Aromatase inhibitors
-Medroxyprogesterone (depot)
28-wt is the other Secondary causes of osteoporosis-Inflammatory disorders (eg, rheumatoid arthritis)
-Multiple myeloma
29-how postconcussive syndrome following mild traumatic brain injury present and wt is the prognosis .headache, confusion, amnesia, difficulty in concentrating or with multitasking, vertigo, hypersensitivity to various stimuli, mood alteration, sleep disturbance, and anxiety.

These symptoms typically resolve with symptomatic treatment within a few weeks to months following TBI; however, some patients may have persistent symptoms lasting >6 months.
30-wt is the classic triad of Meniere's disease.1-periodic vertigo
2-unilateral hearing loss

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